Over the past several years, a number of orthotic braces referred to as "walkers" have been developed for replacing use of plaster walking casts which have previously been used in the rehabilitation of ankle fractures. Normally, an ankle fracture is treated by holding the foot in a neutral position and immobilizing the ankle in a rigid cast from below the knee to the toes. After six to eight weeks a walking boot cast is applied and weight bearing is permitted. The walking boot cast also immobilizes the ankle joint.
The ankle fracture walkers have many advantages over the rigid walking boot cast. The ankle fracture walkers are easily removable from the lower leg, ankle and foot, and they can be easily placed back in a supporting position, often without the assistance of a medical professional.
These ankle fracture walkers generally include a foot supporting shoe, referred to as a "rocker", which includes a rigid shell that fits around and under the foot. A curved sole on the bottom of the shell permits a rocking heel-to-toe motion of the foot during use. The rocker usually attaches to the leg of the patient by rigid or semi-rigid uprights extending along the lateral and medial sides of the leg above the ankle joint. The uprights are commonly affixed to a semi-rigid or soft means of support that wraps around the lower leg and ankle joint. Fasteners carried on the upper portion of the walker are wrapped around the patient's leg to provide the necessary support, and similar fasteners firmly affix the rocker to the patient's foot. The bottoms of the uprights are rigidly affixed to the opposite sides of the rocker to immobilize the patient's ankle joint so as to hold the ankle joint at a fixed angle of about 90.degree. (the angle defined by the lower leg and the ground) when the walker is in use. Some ankle fracture walkers may immobilize the patient's ankle joint in a slight angle from 90.degree., depending upon the injury.
The natural configuration of the rocker permits the patient to closely simulate a normal walking gait while wearing the walker, while the affected ankle joint is stabilized to limit motion in any direction. As a result, the patient's ankle is held at the fixed angle while weight can be applied to the affected area during walking. The walking motion is assisted by the rounded bottom configuration of the rocker.
Prior art walkers have primarily been used in the rehabilitation of stable ankle or foot fractures usually following surgery. They also have been used during rehabilitation of severe ankle sprains or strains or other ligament damage to the ankle. The prior art walkers have provided many advantages to the patient when compared with a rigid cast. For instance, they save time normally required to apply a plaster cast, and cast complications are avoided. The walker can be applied in an adjustable snug fit and can be easily removed. This provides convenient access to the afflicted joint. Since the patient can come out of the cast earlier and begin walking, healing is improved and the rehabilitation period is shortened as a result of weight-bearing while walking. Weight-bearing decreases atrophy, maintains propriception, and reduces edema.
The present invention is directed to an ankle fracture walker that significantly improves the rehabilitation process for an ankle fracture in a manner that is not possible with the proir art walkers described above. The walker of this invention allows a controlled angular range of ankle motion during weight-bearing on the ankle joint while the ankle joint is supported by the walker and while the patient walks at a normal walking gait controlled by the walker. As a result, the ankle fracture walker greatly enlarges the methods of treatment of ankle fractures during the rehabilitation process. The ankle fracture walker can be adjusted throughout the rehabilitation process to allow maximum mobility of the ankle joint during weightbearing, depending upon the type of injury involved and the patient's progress in healing. Rehabilitation is functionally better for the patient and total rehabilitation time is reduced when compared with patients using the prior art fixed-angle walkers.